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7599415 tn?1392453444
i'm gonna have the peg,in one or two weeks. have some questions
here is my condition.http://www.medhelp.org/posts/Hepatitis-B/my-hbsag-is-35639IU-mi-need-advise-please/show/2216087#post_10625469
1.should i take tenofovir while injecting the peg? because i once heard taking tenofovir could suppress my immune system.
2.should i stop injecting when my hbsag is underdetectable?
3.when should i use hepatitis B vaccine?
your advice will be very important. thanks
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post your latest hbsag quant in iu/ml, your hbv genotype, hbeag and hbvdna, vitd25oh level

if hbeag neg
pegintf can work only if hbsag less than 1000iu/ml, if it is high it is best to go for tenofovir and add pegintf when hbsag has declined to around 1000-1500iu/ml.usually by 5years of tdf 50% of treated get hbsag 1000iu/ml or less
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7599415 tn?1392453444
i'm confused...
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7599415 tn?1392453444
i've checkd my hbsag is 270.35IU last month
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hbsag 270iu/ml?

if so low go for pegintf as soon as vitd25oh is about 100ng/ml, dont add tdf unless hbvdna is very high but i guess it is low with such low hbsag
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7599415 tn?1392453444
my hbvdna is underdetected for 6 years or more. im afraid that the virus would mutate without tdf. could tdf really affect immune system?
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could u tell me the reason why injecting peg without tdf when the hbsag is under 1000 and hbvdna is underdetected? im really confused
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7599415 tn?1392453444
i've read two forum posts which you post:http://www.medhelp.org/posts/Hepatitis-B/Clinical-Trial-results-Combined-PegIFN--Entecavir/show/2387226
http://www.medhelp.org/posts/Hepatitis-B/NUC--Interferon-switch-to-or-add-on/show/2409254
it seems that "add on peg" is better than "Switch to peg"?
what do you think? here is my condition:http://www.medhelp.org/posts/Hepatitis-B/my-hbsag-is-35639IU-mi-need-advise-please/show/2216087#post_10625469
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i thought you were not on treatment.in your case you have absolutely to keep the antiviral tdf and add on pegintf to it.
please update on results, according to the trials you hve 91% chances to clear hbsag and develop hbsab and if you dont clear you will be lowering hbsag anyway

what is your vitd25oh now?because you need to make vitd25oh 100ng/ml and intact parathormone 10-20pg/ml before adding pegintf
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7599415 tn?1392453444
OK, then i will go to some doctor and get some peg in some days
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You have asked a very good question, I am afraid I don't have a definitive answer for you because I am not an expert. Also, I think the profession does not have an answer yet. But in your case, I will agree with Stef2011 that add-on, that is, PegIFN added on to your existing TDF treatment will be the choice.
Basically, the understanding is this: long term use of NUC not only reduces hbvdna but also restores the adaptive immune functions. So it is not true that taking Tenofovir (or other NUCs) suppresses your immune system. Because NUC suppresses the production of hbvdna, it reduces inflammation and hence immune reaction, as indicated by normal ALT and allowing the liver to recover. It has been observed that for some patients, after long term use of NUC, stopping NUC will cause a flare, but will lead to HBsAg clearance. This is the subject of on-going clinical trials and the results are not known. However, in other cases of stopping NUC after long term use with undetected viral load load and normal ALT, a majority of patients will suffer a re-bounce, both in viral load and ALT.
So it does  seem that the restoration of adaptive immune system after long term NUC use may not be sufficient to clear HBsAg on stopping.
Seum HBsAg is known to suppress the immune system, it also acts as a surrogate marker for cccDNA. So a low level of serum HbSAg may indicate a lower quantity of cccDNA and more immune control. PegIFN is known to reduce HBsAg, and it also modulates the innate immune system. Therefore, when serum HBsAg is low, adding PegIFN to NUC may restore innate as well as adaptive immune functions, with further lowering of serum HBsAg to reduce suppression of the immune system, all these may lead to a higher chance of clearing HBsAg.
Of course, some researchers believe combination of PegIFN and NUC may not be sufficient, other drugs, such as therapeutic vaccine, cytokines, may also need to be added.
These are just my understanding.
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7599415 tn?1392453444
i've checked yesterday. my hbsag is 249.5iu/ml, my ALT is more than 900, and AST is 348. but to my surprise, my virus data is 0.24*10^3. my doctor asked me to stop PEG and play bottle to reduce the ALT.
my question is can i play bottle while using PEG?
after i talked to my doctor, my doctor still refused to let me use PEG.
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7599415 tn?1392453444
i've checked yesterday. my hbsag is 249.5iu/ml, my ALT is more than 900, and AST is 348. but to my surprise, my virus data is 0.24*10^3. my doctor asked me to stop PEG and play bottle to reduce the ALT.
my question is can i play bottle while using PEG?
after i talked to my doctor, my doctor still refused to let me use PEG.
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I am not familiar with the phrase "play bottle".
I would like to know whether you add-on Interferon to your existing Tenofovir treatment, or did you stop Tenofovir? What is the unit of your viral load: copies or iu /ml?
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7599415 tn?1392453444
sorry, it's "having an intravenous drip"
i didnt stop Tenofovir. and viral load is iu/ml
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Thank you. It is very unusual that your hbvdna increases from undetectable to 243 iu/ml when you are still on Tenofovir. An ALT flare is not unusual with Interferon, but yours seems to be quite high. In Australia and other western countries, doctors do not use "intravenous drip" of certain medication to lower ALT at all, it seems to be in use in China (not even Taiwan or Hong Kong) only.

In my opinion, and I am not a doctor, I think it is reasonable to stop Interferon, but do keep taking Tenofovir, and closely monitor your ALT, say weekly. There is no need for intravenous drip.
Hopefully the ALT flare may lead to clearance of your HBsAg and will return to normal soon. I can only speculate, just my pure guessing with no scientific evidence, that your serum hbvdna may be due to leakage of intracelluar hbvdna when the infected cells are killed.
I hope stef2011 and studyforhope will also comment on your situation.
Do take it easy and keep us informed.
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7599415 tn?1392453444
thank you for your advise. i have no choice. my doctor insist on using intravenous drip. my doctor said i can continue to use PEG when my ALT is under 400.
and do you think this 900 thing has something to do with 10000iu VD3? should i stop VD3?
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I understand. As for your VD3, I am no expert. Personally, I would stop until things settle down. I am sure Stef2011 will have better advice for you.
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Ou need an expert doctor for peg treatment, alt flare at 1000 is the best thing you can dream of while hbvdna und or very low on tdf, this means you are clearing infected cells fast and no need to stop peg as long as liver is not cirrhotic, alt till 1000 is  ok even for cirrhotic liver (i know becasue i had it and this is  what most expert researchers suggested

if you stop the flare you also stop hbsag clearance.if your liver function is ok like plts, bil, albumin, keep peg or just lower dose.

vitd3 is mandatory to regulate immune response, so that you dont get too much th1 response which is the inflammatory one

so please sum up your tests while on peg plus tdf, vitd25oh included and we can suggest

stop any immune suppressive treatment if they are doing that by iv now.corticosteoids are absolutely bad
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ALso look for very expert specialists alt> 1000 and hbvdna<2000 are a sure sign peg  is working and you will clear hbv, this doctor is scared about alt andthat means he is not exprt to manage peg treatment

We had another member here who cleared hbv by peg plus lam with alt more than 1000, i repeat alt flare is an issue on decompensated liver or if tests go in to liver failure, alt is not a measure of liver function
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Ou need an expert doctor for peg treatment, alt flare at 1000 is the best thing you can dream of while hbvdna und or very low on tdf, this means you are clearing infected cells fast and no need to stop peg as long as liver is not cirrhotic, alt till 1000 is  ok even for cirrhotic liver (i know becasue i had it and this is  what most expert researchers suggested

if you stop the flare you also stop hbsag clearance.if your liver function is ok like plts, bil, albumin, keep peg or just lower dose.

vitd3 is mandatory to regulate immune response, so that you dont get too much th1 response which is the inflammatory one

so please sum up your tests while on peg plus tdf, vitd25oh included and we can suggest

stop any immune suppressive treatment if they are doing that by iv now.corticosteoids are absolutely bad
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7599415 tn?1392453444
i still wanna give it a shot. but my doctor didnt give me an option, i have to follow her order so that i will have chance to use PEG in 3-4 days when my alt is under 400. its almost impossible to find an expert in our little city. i even askd some famous doctors online. they also agreed on my doctor's decision.
so do you have some papers or research results? so i can show them to my doctor.
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Ncrease vit d 3 levels to 100ng/ml this can help modulate immune system to less aggressive.you can also follow your doctor if you are hbvdna und by tdf evn alt 400 have chances to clear
it is important to restart peg whenalt gets lower and dont let it to normal
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You cant ask online for this because it is too much responsability, the doctor must know your liver status and how it is working while alt 1000 to manage peg safely in this situation, try to search medhelp for peginterferon plus lamivudine alt 1000 maybe you find the story of that member
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7599415 tn?1392453444
these are my test results from my last three month using the TDF and PEG and VD3 10000iu
Jan. HBSAG  316.530iu/ml
       HBSAb   0.32miu/ml
       HBeAG   0.506PEiu
Feb. HBSAG   76IU/ML
Mar.  HBSAG  0.12iu/ml         0.000-0.050
        HBSAb   0.40miu/ml
        HBeAG   0.346peiu/ML   0.000-0.228

truly, i'm pretty happy when i got my test. but my question is when should i use hepatitis b vaccine? which kind i should choose,domestic or import?
BTW,i'm in china.
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7599415 tn?1392453444
these are my test results from my last three month using the TDF and PEG and VD3 10000iu
Jan. HBSAG  316.530iu/ml
       HBSAb   0.32miu/ml
       HBeAG   0.506PEiu
Feb. HBSAG   76IU/ML
Mar.  HBSAG  0.12iu/ml         0.000-0.050
        HBSAb   0.40miu/ml
        HBeAG   0.346peiu/ML   0.000-0.228

truly, i'm pretty happy when i got my test. but my question is when should i use hepatitis b vaccine? which kind i should choose,domestic or import?
BTW,i'm in china.
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You have good reasons to be happy, and so are we. Congratulations.
I don't know when you should use the HBV vaccine. I would think you should first complete your course of Interferon. It is a pity that the best HBV vaccine Sci-B-vac from Israel (now taken over by Levon) is not more widely available. I am sure stef2011 will give you better advice.
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Hello there.i just want to share with you the lab test of my husband. he is injecting peginterferon alpha 180mg for 9 months.his hbvdna now is 27 before it was more than a million..his hbsag now is 167, before it was more than 5500. his alt now is 190 but last january it was only 160 but before he injected peginterferon it was 425. his sgot is 130 now last january it was 106. his triglycerides now is 256 but last january it was only 201....last november his doctor prescribed him to take ursofalk to lower his alt but the result was his triglycerides elevated and he was brought to the hospital because he felt dying....my question is how come his triglycerides dont go normal. he is too disciplined with his diet.
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Hello there.i just want to share with you the lab test of my husband. he is injecting peginterferon alpha 180mg for 9 months.his hbvdna now is 27 before it was more than a million..his hbsag now is 167, before it was more than 5500. his alt now is 190 but last january it was only 160 but before he injected peginterferon it was 425. his sgot is 130 now last january it was 106. his triglycerides now is 256 but last january it was only 201....last november his doctor prescribed him to take ursofalk to lower his alt but the result was his triglycerides elevated and he was brought to the hospital because he felt dying....my question is how come his triglycerides dont go normal. he is too disciplined with his diet.
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the dr of my husband said that he should finish the 48 injections...will that be ok to finish even if his hbvdna is only 27 from a million.. ang his hbsag quantification is only 167 from more than 5500?
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Hello there.i just want to share with you the lab test of my husband. he is injecting peginterferon alpha 180mg for 9 months.his hbvdna now is 27 before it was more than a million..his hbsag now is 167, before it was more than 5500. his alt now is 190 but last january it was only 160 but before he injected peginterferon it was 425. his sgot is 130 now last january it was 106. his triglycerides now is 256 but last january it was only 201....last november his doctor prescribed him to take ursofalk to lower his alt but the result was his triglycerides elevated and he was brought to the hospital because he felt dying....my question is how come his triglycerides dont go normal. he is too disciplined with his diet.
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I am not a doctor. I googled "high triglycerides interferon" and found this:
"Elevated triglyceride levels have been observed in patients treated with interferons, including interferon alfa-2a. Triglyceride levels should be monitored during treatment and should be managed appropriately. Hypertriglyceridemia may result in pancreatitis. Interferon alfa-2a should be discontinued in patients with persistently elevated triglycerides (e.g., greater than 1000 mg/dL) associated with symptoms of potential pancreatitis, such as abdominal pain, nausea, or vomiting."
http://www.drugs.com/dosage/interferon-alfa-2a.html

I also googled ursofalk, it is bile acid and can cause nausea and vomiting. I know of no medication to directly lower ALT, so I don't know why his doctor prescribed such medication. It should be stopped.
However, I do agree with his doctor that your husband should complete the 48 weeks of injection. We don't know the full history of your husband's Hepatitis B, but obviously he is responding to Interferon treatment. You may like to discuss with the doctor about continuing Interferon further, if his hbvdna and HBsAg levels keep falling. It may lead to a cure. The rise in ALT(SGOT) is a good sign and is not high at all. By all means, monitor his triglycerides level.

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Thank you for the reply you are so kind and a blessing...that is also the reason why his amylase elevaed from normal to high..now its amylase is 129 the maximum for it is 110 only..what can you sugest and how can i monitor his triglycerides?
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Again it is beyond my knowledge. I googled amylase, it's elevation may be related to the pancreas. By monitoring, it is meant that he should have frequent blood tests to check the triglycerides level. Talk to the doctor.
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he is injecting peginterferon alpha 2a 180mg....should i worry about his elevated triglycerides? this coming june 24 will be his last injection..he is injecting once a week....i insisted to his dr everytime he gives him medicine to take for his sgpt to decrease hi triglycerides indreases..and when he takes medicine to lower his triglycerides, his sgpt increases....
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i agree with steph if you had such a fast response by 3months only it is extremely probable you will develop hbsab by 48weeks.

i hope you might get hbsab by 24 weeks already which is a possibility here
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sorry we are not doctors and our knowledge is very good as regards liver, hbv and its therapies but when it comes to other organs/drugs we cannot suggest anything.
peg results are very good so i agree on going for 48weeks

you may discuss using high dose omega 3 fish oil with your doctor, it does lower triglycerides but it may have interference with ursofalk which i dont know and blood clotting

by the way is vitd25oh monitored?is it on high end of normal 90-100ng/ml?are you taking 5000-10.000iu of vit d3 daily?
as regards vit d3 we can suggest to use it as soon as possible, it does have no controindications and without it pegintf might not respond, respond partially and make too much inflammation/sides effects.this is definitely the first thing to check before starting pegintf therapy so that it is not deficient
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is it really once a week schedule for the peginterferon alpha 2a 180mg injection?
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i dont know vitd25oh...what is that? is it a labtest?
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my husband is not taking any vitamins. he is only injecting peginterferon alpha 2a 180mg once a week...
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Yes, PEGIFN is a weekly injection. My personal opinion is that his alt(sgot) is not high and you should not take any medication to lower it! No such medication exists as far as I know. As for his triglycerides level, it is not high, according to what I googled to warrant any action. It is most likely a side effect of interferon, so just talk to your doctor.
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thank you very much for your time and effort to google. i appreciated it very much. and i felt happy with what you said that peginterferon has good effect to my husband...god bless you more. likewise to stef2011 god bless and thank you to both of you..
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high alt is good on peg, it means peg is working.alt till 1000 is ok even for well compensated cirrhotic liver although liver function must be checked very carefully and often

as steph checked your levels and those are not high, i think you are just experiencing pegintf inflammation/fatigues sides.i do suggest you start vitd 10.000iu daily as soon as possible and then go for vitd25oh test (vit d levels).all hbvers are deficient and this deficiency may limit pegintf response and increase sides effects

ursofalk....check with doctor why it was used and why he wanted to lower alt since 130 is not high.are you sure your husband liver is not cirrhotic?do you have fibroscan or biopsy before stating peg?
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vitd 10.000iu

sorry vit d3 10.000iu daily in extra virgin oilve oil, be sure it is not d2 and it has no calcium.
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please remember to update us how it goes at 24 weeks
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7599415 tn?1392453444
should i use the vaccine? is there difference in the Hbsab between using vaccine and getting it by myself?
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and i will update my results in time
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should i use the vaccine?

no i think you will develop without vaccine although we can t be sure 100%

is there difference in the Hbsab between using vaccine and getting it by myself?

better get it by yourself, vaccines have preservatives which are often toxic like mercury or similar, best get hbsab by pegintf or zadaxin
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How long do you have to go on IFN and TDF?

Agreed with Stef here.

Naturally developed HBsAb is a better antibodies for sure. My antibodies while on IFN went from 55, when HBsAg become undetected (week 36) to 255 (week 45) to 353 (week 50) and 953 (week 65).

So IMO, it should rised up from here as you keep taking IFN.



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Has the Dr ever discussed about reducing your husband's IFN dose to 135mcg?
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no he doesn t need reductions, dose reduction is only for very low wbc/lymphocytes, very low plts or alt>1000.

he better keep this dose because 135mcg has very little response on most patients i think it may work only on those with very strong response (low plts, high alt)
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He had his ultrasound and the result was good.
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Tomorrow we will be seeing his gastro. Wud it be OK do you think if I will ask for a request for my husbands vitd25oh be checked? Is vit d3 10,000
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So if my husband will take the bit d3 you are recommending, will there be less side effects in his triglycerides and amylase?
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He only told us if his platelet count goes below 100 then that is the time to decrease the the of peg interferon
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He was diagnosed with chronic HEPA b
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Can I buy did without prescription?
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What good brand of bit d3 are you taking?can I buy it over the counter with out prescription?
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do you think if I will ask for a request for my husbands vitd25oh be checked?

definitively, so you ll understand if your gastro is updated, low vitd is correlated to poor pegintf response with absolutely proof from studies
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How long will vitd3 be taken? A month?
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will there be less side effects in his triglycerides and amylase?

no sides effects are from immune response, with null sides there is null response very often, although some may have no sides and immune response too

What good brand of bit d3 are you taking?can I buy it over the counter with out prescription?
yes i take healthy origins 10.000iu from bigvits uk.i dont know if vit d is free from prescription everywhere but should be

He only told us if his platelet count goes below 100

expert doctors wait till plts 25.000, there are also wait to manage this by drugs/transfusions.but it is rare to go so low as 25.000
i had plts myself around 80-90.000 no trouble at all and no lowering dose
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Are you still under treatment with your HEPA b or are you already cured? You and your fellows who answers questions are all good...
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still hbsag detectable but i lowered it to very low levels around 700iu/ml
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My husbands DNA is only 27 and his hbsag quantification is 167.. Do you in 3 months time it will be lowered fast with vit d3? I will include you in our daily prayers that you will all get well by gods grace
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By the way my husbands gastro said that there must be 0 transformation in the HEPA profile result...hbsag must be 0 he said to become non reactive? Is that true?I want to shift to another gastro our place is far from the city
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once you reach hbsag 10-100iu/ml your husband has high chances to clear even off peg, the best thing is keep peg until hbsag is cleared and hbsab>10-200miu/ml, the maximum potency of pegintf is reached between 48 and 96weeks so it is best to keep pegintf longer than 48weeks

anyway you have high probability even at 48weeks.vit d will help for sure but we cannot tell if it will boost hbsag clearance, we will see
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Wooow what a lesson are we grabbing from this thread love it & Wish to all the hbver's a fast recovery & cure.
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True we are learning through our personal experiences and determination to be cured
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Is it ok if my husband is drinking warm lemon water before breakfast?
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I would like to share this to everybody. In order to maintain the normal platelet count of my husband because he is injecring pegasys 180mg, I boil him sweetpotato leaves and malunggay leaves. That what he drinks every day.bcoz camote tops is a good source of iron.and malunggay is also nutritious.
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I drink every morning before the breakfast a 500ml of lemon water i don't warm it though, any specific advantage over the cold one? Appreciate.
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Hello.my husband went to his gastro for his quarterly Chek up.the doctor again gave him a prescription of ursofalk and godex ds in which according to the doctor that will lower his shoot. His sgpt is 190. But ursofalk almost killed my husband and I told that the doctor. He just lowered the dose 250 mg 3 x a day...I did not buy the meds coz I know it will put my husband at risk again...I want to tell the gastro what I learned from you and steff which I truly believe in your googled info.but I only respect his feelings, he might get offended. Until now my husband don't have a request for vitd25oh..and the doctor is not aware that vit d3 is good with pegasys
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Hello.my husband went to his gastro for his quarterly Chek up.the doctor again gave him a prescription of ursofalk and godex ds in which according to the doctor that will lower his shoot. His sgpt is 190. But ursofalk almost killed my husband and I told that the doctor. He just lowered the dose 250 mg 3 x a day...I did not buy the meds coz I know it will put my husband at risk again...I want to tell the gastro what I learned from you and steff which I truly believe in your googled info.but I only respect his feelings, he might get offended. Until now my husband don't have a request for vitd25oh..and the doctor is not aware that vit d3 is good with pegasys
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godex
Per cap: Carnitine orotate 300 mg, pyridoxine HCl 50 mg, hepatic extract antitoxic fraction 25 mg, adenine HCl 5 mg, riboflavin 1 mg, cyanocobalamin 250 mcg

low carnitine levels correlated with hbsag loss on pegintf plus adefovir on a big study, so not sure carnitine are useful

hepatic extract antitoxic fraction 25 mg...so generic who knows what this is.some antioxidants may not be good because they can lower inflammation which is required for immune response.much better lower inflammation  by vit d3 which modulates immune system

riboflavin 1 mg, cyanocobalamin 250 mcg
these are vitamins, good but they dont make a difference on pegintf response
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Ursofalk is a remedy for gallstone and biliary cirrhosis. So I don't know why your doctor is prescribing it for your husband. You have to ask him why? If he said it is to lower ALT(SGOT), ask him for evidence. There is no medication to directly lower ALT and it is definitely not appropriate here.
Get a second doctor's opinion.
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Most of the doctors here have the sae medicines that they prescribed. You are lucky in your country because your gastro are updated...here, they don't even know that vitd25oh must be tested before injecting Pegasus. Also they don't know that vitd3 is a good supplement
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I thought all gastro doctors are all well educated and updated. He only told us to inject Pegasus but don't know the side effects that my husband may experience
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How can I buy vbit d3 and how can I have a request inorder for my husband to undergo viutd25oh
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I guess we have the same feeling. He should master his specialization. He should be a wide reader....and he shud read our posts so that he will learn a lot..
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it should not be difficult to find vit d3 over the counter, check amazon if not available at pharmacy

in europe i get it from bigvits uk or from other german websites
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The vitd25oh result of my husbnd is 174.80nmol/L..is this ok?
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The unit to use is ng/ml not nmol/l which are confusing, ask lab esult in ng/ml
the target is 100ng/ml and intact pth 10-20pg/ml, i m not sure but 100ng/ml should be 250 or 400nmol/l

To know if sufficient get both result in ng/ml and pth
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Conversion rate is 2,5 so seems that his level is 69 ng/ml
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Its 69 ng/ml....what can you suggest
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Thank you..whatbcan you suggest to totally decrease his hbvdna of 27 and hbsag quantification of 167?
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7599415 tn?1392453444
sorry for not updating so long. after ten months' peg + tenofovir, i've got HBSAB last month from Hepatitis B vaccine(60ug).and i plan to get the other injection until my hbsab reach 100 or more.
my question is that how long can i stop tenofovir? should i take it for one or two years?
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7599415 tn?1392453444
and my hbsag is 33 for now
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And what about your viral load?
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viral load is und being on peg+tdf
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you have to keep tdf until hbsag und and hbsab high stable for 6-12 months

so please repost all results and if you are still on peg, hbsag 33iu/ml, hbsab?
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can't you just keep peginf a bit longer until HBsAg becomes und ?
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Coule a patient decide whether if continue peginterf or just doc who decide?especially in case of getting result of very low hbsag value?
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Some doctors basing on their experience may ask patient if they want to continue if they see it makes sense, in that case it makes definatelly. 48 weeks is just minimal period when you start to see some good results.
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7599415 tn?1392453444
i'v had enticavir for 8 years , and tenofovir for 2 years. its obviously below the limit of detection
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7599415 tn?1392453444
it is my hbsab that is 33 iu, my hbsag is und in the May. so could ii stop peg?
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i think studyforhope is the best to help us

personally i think hbsab 33miu/ml is still too low and i would keep peg a little longer if possible using at least one or two courses of hbv vaccine or even better find zadaxin and in this case stop peg and keep zadaxin plus tdf until hbsb rises

another choice is stop peg and keep tdf, check hbsab every week and if stable keep using tdf for 6 to 12 months.hbsab test can be weekly at first then every month to every 3 months once we see it is stable
after 12 months of stable hbsab, even if so low, i think it is ok to stop tdf

in the meantime make your vitd25oh levels optimal at around 100ng/ml. another possibility if zadaxin not available and peg must be stopped would be the use of gcmaf to see if it makes hbsab higher, saisei mirai in japan is the best supplier of this, but it is quite expensive and very few members used it so we cannot say for sure it works.
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of all choices stopping peg and making zadaxin+tdf+hbv vaccine is the best

zadaxin is available in few countries, in italy is available
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just saw you are in china so zadaxin is available
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your example is also very valuable, it looks like using pegintf add on after so many years of nucs have very high success, you confirm on our community the finding of the small trials with sequential add on but using add on only after 5-7years of nucs and not 1-2years of nucs
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7599415 tn?1392453444
because of my work situation, may i ask if i can drink alcohol like wine or chinese spirits in the meantime i still use tdf
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7599415 tn?1392453444
and i have had my second vaccine last week. i plan to have a test next month to check my hbsab. if my hbsab is still not arrive at 200, what can i do? still use the third vaccine?
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Woow. Another HBV survivor. thu i am too late Congratulation!
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thank you. hope u can make it too
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i think alcohol may lower immunity i think it is best to avoid it totally now

yes make another vaccine, we have had 2 trials of monthly hbv vaccine in italy for transplant patients and it worked to make hbsab.they lowered immune suppressive drugs dose and made monthly vaccine

check your hbv vaccine brand and if necessary choose the one with no mercury/formaldeide, they use different names for mercury, choose the brand with the least harmful additives
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7599415 tn?1392453444
then when can i use some drink?
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you may also take these supplements to boost response to vaccine, this is a weak formula of gcmaf but approved, cheap and easy to buy.i think the cream on area of hbv vaccine injection and sublingual drops are good.this gcmaf form has no sides effects
http://mafactive.com/mafactive-range/

one member on tdf who had low hbsag 16-25iu/ml for a very long time cleared hbsag after using sublingual gcmaf, this maybe a coincidence but it doesn t harm to try this.
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when we see hbsab rises stable to over 200miu/ml

do contact the guys on mafactive website, they used to make discount if you give feedback on http://www.gcmafresearch.com/
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